HomeMy WebLinkAboutBUSINESS PLAN Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON REVERSE SIDE
........ ,,~,~,~?!?.? ~!~:~,~ ~,,~ ,,,., This permit is issued for the following:
PERMIT ID# 015-O21e01056 ??ii 'i ~,~i~ iii ?~:i~' i!!!:!::~!!!![!!~!!~!!~i~2[!!!!!?~::~!!!~!?!!!!!~=~iiii~!!~?~ik ~nagement Program
~1'"' :J;jc
LOCATION ' 127
'~
Issu~ by:
B~ersfield F~e Depa~ment Approv~ by:
OFFICE OF
~7Z5 Chewer Ave., 3rd Floor
B~e~6el~ CA 93301
Voice (805) ~26-3979
F~ (80S)~26~S76 Expiration Date: dUn~ ~0~ ~0OO
SITE/FACILITY DIAGRAM ..
FORM 5
NORTH SCALE: BUSINESS NAME~,,/_~.,~Q~Z_~ ~".Z~. ~.~ FLOOR: / OF/ .
(CHECK ONE) SITE DIAGRAM FACILITY DIAGRAM /
~Inspector's Comments): -OFFICIAL USE ONLY-
S~T~ D[AGR~AM (R items).
,.; 1. Address: Identify the 9. Lock Box
~ principle buildings '
~' ' by the Street numbers. 10. MSDS Storage Box
2. Street(s), Alleys, I1. Railroad Tracks
Driveways, and Parking
Areas adjacent to the 12. Fence or. Barrier '
property. Include the .,:, a. Wire
street names.
b. Masonry
3..Storm Drains, Culverts,
Yard Drains c. Wood
4. Drainage Canals, Ditches, d. Gates
Creeks, -~'" -
13. Powerltnes ,-
5. Buildings '
a. Frame construction 14. Guard Station '
b. Masonry construction 15. Storage Tanks:
Identify the
c.-Metal construction capacity in gal,
a. Above ground
d. Access Door
b. Underground
6. Utility Controls
a. Gas 16. Diking or Berm
b. Eiectrlcity 17. Evacuation Route
. .- ~:.
c. Water 18. Evacuation Area:
Identify the
· ?. Fire Suppression Systems: location where
a. Fire Hydrants employees will
meet.
b. Fire Sprinkler 19. Outside Hazardous
Connections Waste Storage
" c. Fire Standpipe 20. Outside Hazardous
Connections Material Storage
d. Water Control Valves 21. Outside Hazardous
for protection systems .,Material
Use/Handling
e. Fire Pump 22. Type of Hazardous
Material/Waste
Stored
-8. Fire DepartIent Access or Used (See
Below)
TYPE OF HAZARDOUS MATERIAL
F = Flammable E = Explosive L = Liquid R = Radiological
C = Corrosive 0 = Oxidizer O = Gas P = Poison
W = Water Reactive T = Toxic S = Solid H = Cryogenic
D = Waste B = Etiological
Example: Flammable Liquid = FL
FACILITY DIAOR~ (Required items in addition to the abo~e)
1. Risers for Sprinklers 8. Fire Escapes '
2. Partftions 9. Air Conditioning Units
3. ~talrways: Indicate 'the 10. Windows
levels served from
highest to lowest.- 11. Inside Hazardous Waste
Storage
4. Escalator: Indicate the
levels served from 12. Inside Hazardous
highest to lowest. Materials Storage
5. Elevator 13: Inside Hazardous' . '
Materials Use/Handling
6. Attic Access
14. Sewer Drain Inlets :
08/18/9'2 BAKERSFIELD CITY FIRE DEPT #6 215-000-001056 Page 1
Overall Site with 1 Fac. Unit
General Information
LOcation: 127 BRUNDAGE'LN 'Map: 103 ~az~rd: Low
Community: BAKERSFIELD STATION 06 Grid: 31'D ,~/U: 1 AOV: 0.0
Contact Name Title Business ~o ~ 24-Hour Phone-
D~NN~S ~E~49H4~M IFIRE CHIEF I (805)326-39.1'~ (805)~4~'m~-7~
MIKE KELLY DEPUTY FIRE CHIEF (805) 326-391i
Administrative Data
Mail Addrs: 2101 H ST ' D&B Nu~er:
State~ CA Zip: 93301-
City: BAKERSFIELD
Co~ Code: 215-006 BAKERSFIELD STATION 06 /SIC Code: 9224
/
Owner: CITY OF BAKERSFIELD /Phone: (~f)~ -~/
Address: 1501 TRUXTUN AV /' State: CA
City: BAKERSFIELD ' ~ / Zip: 93301-
Sugary'
RECEIVED
SEP '1 4 1992
HAZ.~ MAT.. DIV.
~, ~rr~ ~~ Do hereby ce~i~' that ! have
' reviewed ~he aNached h~afdous materials ma~age-
men~ plan for ~, ~ ~ ~and ~hat it alo~ with
(N~e U
any ~r~ions ~ne[i~ute a ~mple~e and ~rr~ man-
~em~ plan for my f~li~.
08/18/92 BAKERSFIELD CITY FIRE DEPT #6 215-000-001056 Page 2
02 - Fixed Containers on Site
Hazmat' Inventory Detail in Reference Number Order
,02-001 DIESEL FUEL Liquid 1000 Low
· Fire, Delay Hlth GAL
CAS #: 68476-34-6 Trade Secret: No
Form: .Liquid Type: Mixture' Days: 365 Use.: FUEL
Daily Max GAL I Daily Average GAL I Annual Amount GAL
.~ 1,000 ~ 500.00 3,300.00
. Storage Press T Temp Location
UNDER GROUND TANK Iambient~Below ISOUTHWEST CORNER OUTSIDE
-- Conc Components MCP List
100.0% 'lDiesel Fuel No.1 IModeratel
02-002 UNLEADED GASOLINE , Liquid 2000 Moderate
· Fire, Delay Hlth GAL
CAS #: 8006-61-9 Trade Secret: No
Form: Liquid Type: Mixture Days: 365 Use: FUEL
Daily Max GAL Daily Average GAL I Annual Amount GAL
2,000 I oo.oo oo.oo
Storage I PressT TempI Location
UNDER GROUND TANK IAmbient~Below ISOUTH WEST CORNER - OUTSIDE
-- conc Components. MCP ---TList
100.0% IGasoline ' IModeratel
08/1'8/92 BAKERSFIELD CITY FIRE DEPT #6 215-000-001056 Page 3
00 - Overall Site
<D> Notif./Evacuation/Medical
<1> Agency Notification
<2> Employee Notif./Evacuation
IF A MINOR SPILL OCCURS NOTIFY STATION CAPTAIN. IF A MAJOR OR MODERATE
SPILL OCCURS BATTALION ii AND THE DUTY CHIEF WILL BE NOTIFIED,.
<3> Public Notif./Evacuation. ,
~s~ o/: ~:~ /~rX,~ Aow~ o~ z~:~.
<4> Emergency Medical Pl'an
LocAL EMERGENCY ROOM OF cLOSEST HOSPITAL,
CITY DOCTOR
DR. WILLARD CHRISTENSEN
08/18/92 ! BAKERSFIELD CITY FIRE DEPT #6 ~215-000-001056 Page 4
O0 - Overall Site
<E> Mit igation/Prevent/Abatemt
<1> Release Prevention
<2> Release Containment
<3> Clean Up
/..
~<4> Other Resource Activation
08/18./92 BAKERSFIELD CITY FIRE DEPT #6 215-000-001056 Page 5
00 - Overall Site
<F> Site Emergency Factors
<1> Special Hazards
<2> Utility Shut-Offs "
A) GAS - NORTH EAST CORNER OF BUILDING - OUTSIDE
B) ELECTRICAL - NORTH WALL SHOP AREA (INDIVIDUAL BREAKERS)
NORTH WEST CORNER - INSIDE (MAIN)
C) WATER - MIDDLE OF EAST DRIVEWAY - APPROXIMATELY 10 FEET FROM STREET
D) SPECIAL - COMBINATION LOCK ON OUTSIDE DOOR/GATE #1529
E) LOCK BOX - NO
<3> Fire Protec./Avail. Water
PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS AND WATER
FIRE HYDRANT - LOCATED DIRECTLY IN FRONT OF THE STATION
<4> Building Occupancy Level
08/18/92 BAKERSFIELD CITY FIRE DEPT #6 215-000-001056 Page' 6
00 ~-overall Site
<G> Training
<1> Page 1 .
ALL EMPLOYEES ARE EMERGENCY RESPONDERS~AND ARE TRAINED ACCORDINGLY
<2> Page 2 as needed ·
<3> Held for Future Use
<4> Held for Future Use
CITY OF BAKERSFIELD
l-~ Farm and Agriculture ~ Standard Business Page /of
: i NON - TRADE sECRET
BUSINESS NAME:/3f.~.~ i~a/~X + OWNER NAME: ~,~-~- o/ ..~p.~ NAME OF THIS FACILITY:
~R ~ INS~U~IONS ~R PROPER ~DES
i 2, 3 4 5 6 7 8 9 10 1! · 12 13 14
Trna ~e ~ Average ~nual Measure ~ Days Cent Cent Cent Use Location ~ere % by N~s of M~ture/C~nents
Code C~e ~t ~t ~t Units on Site ~ Press Temp Code S~red tn Facility ~ See Instructions
(Chs~k all ~hat ap9ly) :
~ Fire Hazed ~ Sudden R~l~a,, '~ R~tivity ~ I~ediate ~ Delay~
of Pressure H~lth H~lth Component ~ 3 Na~ & C.A.S. N~er
~ Fire Hazed ~ Sudden Release ~ Reactivt'ty ~ l~ediate ~ Delay~ -.-
o~ Pressure H~lkh H~lth Component 8 3 N~ & C.A.S. Nu~er
{Chock ~11 tha~
Compon~t ~ 2 Na~ & C.A.S. Nu~er
'~ Fire .az~d ~ Sudden Release ~ R~ctivity ~ I~iate ~ Delayed
of Pressure H~lth H~lth Component ~ 3 Na~ & C.A.S. Nu~er
Physical and H~lth Hazard C.A.S. N~er Co~onent ~ 1 N~ & C.A.S. N~er
(Check all t~t apply)
component ~ 2 N~ & C.A.S. N~er
of Pressure Health H~lth Co~o~t ~ 3
E~RGENCY CONTACTS ~1 ~2 -
Na~ Title 24 ~. Phone N~e Title 24 ~ Phone
Certificat~on (~ ~D SIGN AFTER COMPLETING ~L SECTIONS)
I certify ~der p~nlty of law t~t I haver ~rsonally ~in~ ~d ~ f~ili~ with the info~t~on submitted ~n th~s ~d all attached d~ts ~d ~at ~sed on ~ '~n~i~ of those
~ndividuals res~nsible for obta~ning the info~t~on. I believe t~ ~he submitted info~ation ~s t~e, acc~ate, and c~plete.
NAME-AND OFFICIAL TITLE OF OWNER/OPERATOR OR OWNER/OPERATOR'S AUTHORIZED REPRES~_ATIVE SIGNATURE DATE SIGNED
BAKERSFIELD CI?f FIRE DE?AR
. B~ERSFiELD, CA 93301
BUS INESS N~ME '
FORM 2A
1.. To avoid ~urther action,
2. ~PE/PRI~ ~SWERS .IN E~GLIS~.
3. Ans~e~ the ~es~ions below for ~he. business as a whole.
4. Be ~s brief and concise as possible.
SE~!ON !: BUSI~SS ~I~!CATI~ DATA
B. BOCATION / STREET ADDREss: /~
SECTION 2: EA~ERGE~.TCZ .YOT!F!CATIONS
In case of an emer~enc¥-'lnvolvin~ the release or threatened release of a.
hazardous material, c~l! 91! and 1-800-8~2-7~0 or 1-91S-427~4341.. ~is'wiI!.notify
your Ioc~! fire depar~men~ ~d ~he St~e Office of
_mer~_..C: Services as required by
E}IPLOYEES TO NOTI~ IN CASE OF E}IERGE~Cf:
N~E A~ TITLE D~ING BUS. HRS. AFaR BUS. ~S.
SECTION S: LOCATION OF UTILIT'f SFfOT-OFF$ FOR 8USI~FESS .~S A r~OLE '
A. NAT. GAS/PROPANE: ~ ~o~ o/ ~/Z~/~ -o~x~ .
C. WATER: ~k~o~ ~ ~ 0~,~- /~/~~Z~- /¢' ~
E. 50CK BOX: YES ,,'~ IF YES, LOCATION: ~z~ ~d¢~ .
· -, v . MSDSS? YES
IF YES, DOES ~T CON~.,L, SiTE PLANS? YES /
FLOOR PLANS? YES / ];0 ' KEYS7 YES '/
SECTYOM ~: 50CAL EMERGE)~CV .MEDICAL ASSISTANCE .~OR ?OUR 3USi.N'ES$ AS A .WHOL,-- ' '-
SECTION S: EMPt0ifEE TRAINING
E."~.?-O'.,,~RS ARE REQUIRED ?0 F~'E A PROGF~'~.~! WHICH PROVIDES E.[P%0'~ES WITH ~)IiTiAL'
REFRESHER T~E)~iNG EN THE ~' "'
FOL,~,~r.,G AREAS.
CIRCLZ L~'S 0R h'O '" iNiTiAL REFRESHER
A. METHODS FOR SAFE HANDLING .OF HAZAREOUS
B. PROCEDURES FOR C00RD[NATiMG ACTIVITIES' -'
WITH RESPONSE AGENCIES ~S N'O ~S 5'0
C. PROPER USE OF SAFE~Z EQUIPMEnt: .................. ~S. 5'0 ~S ~0
· ;~ ...... = ~RAL~.,G RECORDS: .......
SECTION T: ~Z~DOUS MATERIAL'
CIRCLE YES - NO - NO~
DOES Y05~ 3USi~iESS HASSLE HAZARDOUS' ',~TV=!AL 'v QU ........ ~, LESS -w ,-
SOLID, 5~ GAkLONS 0F A LIQUID, 0R Z00 CUBrC FE=T-, 0F A.CC."~=:rSS=D- GAS: ...... YES
cern!fy tha~ the above informa[ion is
r unders[~d ~ha~ ~his information wi!l be used ~o ~' '~:~ '
~u~,_l ~y firm ~ obii~cions under
~he new California Heai~h and Safe~y. code on Hazardous :~a~erials (Div. Z0 c'~,...,~e._. 6.95
Sec. 25500 Et Ai. and ~hat inaccurate informa[ion constitutes perjury..
S [ GZ~ATURE ~ ~ · ~ ' ,DATE
" BAKERSFIELD CITY FIRE'-DEPARTME.XT
2130 "G" STREET
: 'BAKERSFIELD, CA 93301 -
I OFF.'~?Ai USE ',~vrv '
'.. . ID~
BUsINEss PLAN
· SINGLE FACILITY UNIT
FO~RM SA : . .
~NS~UCT~ONS '. ..
, I.., To avoid further action., this 'form musg be re'tuz'ned by ..
2. TVPE/PR!NT YOUR ANSWERS IN ENGLISH.
3. ~nswer the questions be]ow fer ~=r
. C~NC~oa as possible.
4 Be as BRIEF and ~' ~'~
SECTION 1: ~ITIGAT!ON, PR~5~ION~ IBA~ME~ PROCEDb$ES
SECTION '~: NOTTFTCATiON AND EVACUATION PROCEDL,-RES AT Tl-I!S' U."TT OYi. Y
~ECTION 3: HAZARDOUS MATERIALs FOR THIS b~.'IT, oNlY . :. . ~ ·
A..'Does-this Facility unit contain. HazqrdouS/Materia!s?.. .... :. ~' 5'0 :'' .
· I'f YES,' see B"'- . . .
If NO, continue With SECTION 4. "..
'B."Are, any of ~:he hazardous, materialS~a bona f~de.TradeLSecret YES
I~.So, complere'a sepa'~ate hazardous mate'r~als inuentory· '
form marked: NON-TRADE SECRETS/ONLY (white form =4A~1)
!f Yes, complete a haZardous.~a~erials inventory form marked
TRADE .SECRETS ONLY (yellow form =4A-2) in
addition to. rim n°n/.t~ade
.Secret form.: List only the trade secrets :on form.4A-2. ": j .... . "
SECTION 4: PRIVATE 'FIRE PROTECTION :
~_~ ~ ~ /0- ~,'~ ~ ~,~ w,~/j~" ~ ~ .~ o'-~ .'./~ o.-.~.'C
SE~!0N 5: LOCAT!0N.0F WA~R SUPPLY FOR USE .BY E~RGEN~ RESP0h~ERS "
SECTI'O.~ 6: LOCATION OF LWILITY SH%W-OFFS AT THIS L~!T ONLY.
B. ELECTRICAL: -','
SPr. C sA~: .'
E... LOCK 'BOX: YES '.."(~ .'f_Y YES, ~.OCATIOX': .
~ ~o~ .,' '
IF 'YES, SITE PCA;~S? YES / ~'0.:~ MSDSs? YES ."' X'O ' ' "'
. :. . ,. gLoOR PLAXS? ' YES : XO' ~' ~EYS? YES .( N'O
NON--'IrRADE SECRETS /
d~O~ d~ ADDRESS: STANDARD IND. C~AS$ 'CODE
C~TY, .ZIP:. ~~, ~,~ ~ CITY, ZIP: DUN AND BRADSTREET NUHBER
lrb~ T~ ~x A~e ~1 ~su~ I ~ Cmt ~t ~t ~ L~ttm ~ ' ~ ~ ~ ~ N~xt~/~ts
(~ C~e . Mt ~t Est Units ~ Site T~ ~l T~ ~ .. St~ tn F~tlfty ~ ~ I~t~ti~
~ FireHazlrd ~--~ ~ttv~ty ~ll~ ~ hl~ u_~
P~icll ~ ~lth Haze~ C.A.S. ~ ~t II ~ i C.i.S. ~
(C~k i11. t~t apply) ~~*~ ~ ~ ~ ~ '
~-~ ~ ~-] ~-~ ~t, ~&C.A.S. ~
~lth of Pm~ ~lth .... ' ..........
~t 13 ~&C.A.S.
_.,~_[__~ .... L,~ ....... L I ! I- ! I I ! .....................
P~tcil ~ ~]th ~zl~ C.A.S. ~ ~t II h & C.A.S. ~
(C~k ~11 t~t apply)
I~-~ . r--~ ~--~ ~--~ r--~ ~t 12 Nm&C.A.S. ~
H~lth of P~su~ HNith
~t 13 ~ & C.A.S. ~
..,~__L,,,__k .... :.~ ..... ~ .......... ~. ~ _.t__t.~~.._2 __
P~icll ~ HHlth ~Zl~ C.l.S. ~ ~t II h & C.A.S. ~
(~k all t~t
C~t 12 ~&C.A.S. ~
H~ith of Pr~surl H~lth .......
........................ .......... . ....
na~'~ ................................... ~T~i ....................... TI-RF-P~ ....... ~G' T1~11' ~r'~! .......
CeFttficat~ (Reed and ~.~ aftor co.pier,nE all sections)
[ certify ~der ~lty of 1~ t~t I ~ve ~rs~ellyexamn~ e~ am fNiliar wtth t~ tnfor~t~m su~tt~ Jn thts ~ Ill IttK~ ~ts, ~ t~t ~s~ ~ W ~u~ of t~e t~tvi~ls .r~sible '
for obtainin9 t~ inf~mti~, I ~!ieve t~t t~ su~itt~ info~ti~ is t~, 4ccurote,'ind cmplete.__~-- . --
, ,
~- ~a-~TT]~]~]-T;I1;'~T'~iT~T~'Og-~;7~[~ T-~I~]~';;~EI~t]~i ~;~;l~;t .......................................... 5Ti']]j~G ............................ I